How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $66.07 | Facility | None | $52.48 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $95.50 | Professional | None | $53.70 | $66.07 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $138.04 | Facility | None | $81.28 | $128.82 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $331.13 | Professional | None | $60.26 | $67.61 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $251.19 Typical High $251.19 | Professional | UE · Used equipment | $51.29 | $251.19 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $186.21 | Facility | None | $83.18 | $114.82 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $204.17 | Professional | None | $128.82 | $158.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $177.83 | Facility | None | $100.00 | $100.00 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $575.44 | Professional | None | $85.11 | $100.00 | $575.44 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | None | $75.86 | $75.86 | $91.20 |
United Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $87.10 | Professional | None | $42.66 | $63.10 | $87.10 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $33.11 Typical High $47.86 | Professional | 52 · Reduced service | $26.92 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $13.18 Typical High $19.05 | Professional | 53 · Discontinued | $10.72 | $13.18 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.00 Typical High $14.45 | Professional | 55 · Aftercare only | $8.13 | $10.00 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.61 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.37 | $6.61 | $9.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $33.11 Typical High $33.11 | Professional | RR · Rental | $20.42 | $33.11 | $33.11 |
Where Kentucky sits
The same service costs 2.4 times more in Indiana than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kentucky· 51st of 51
$67.61
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.